Vildan KÖLÜKÇÜ, Mehtap GÜRLER BALTA, Yunus Emre KUYUCU

Septorinoplasti olan hastalarda farklı intraoperatif end-tidal karbondioksit (ETCO2) değerlerinin postoperatif bulantı kusmaya etkisi

Amaç: Postoperatif bulantı-kusma (POBK) genel anestezinin en sık görülen komplikasyonlarındandır. Bu durum septorinoplasti sonrası olguların klinik izlemlerinde büyük güçlüklere yol açabilmektedir. Çalışmamızda POBK açısından düşük risk grubuna sahip hastalarda end-tidal karbondioksit (ETCO2) ile POBK arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Genel anestezi altında septorinoplasti uygulanan 18-45 yıl yaş aralığında sigara kullanımı olan ve Amerikan Anestezistler Derneği (ASA) sınıflamasına göre sınıf II olarak değerlendirilen erkek olguların verileri geriye doğru analiz edildi. ETCO2 değeri 26-30 mmHg olanlar Grup 1, 31-35 mmHg olanlar Grup 2 olarak belirlendi. Tüm olguların demografik verileri ve postoperatif 0., 2., 6., 12., 24. saatlerde bulantı-kusma bulguları değerlendirildi. Bulgular: Toplam 73 olgu çalışmaya dahil edildi. Demografik veriler ve operasyon süreleri açısından iki grup arasında istatistiksel olarak anlamlı farklılık yoktu (p>0,05). Grup 1’de postoperatif 2. ve 6. saatlerde bulantı insidansı Grup 2’ye göre istatistiksel olarak anlamlı derecede yüksekti (sırası ile p=0,007 ve p=0,006). Gruplar arası karşılaştırmada postoperatif kusma insidansı açısından anlamlı farklılık yoktu (p>0,05). Sonuç: Çalışmamızda elde edilen veriler ışığında septorinoplasti operasyonlarında intraoperatif ETCO2 değerinin 26-30mmHg arasında tutulmasının erken dönemde POBK insidansında artışa yol açtığı kanaatine varılmıştır.

Anahtar Kelimeler:

End-tidal karbondioksit, bulantı-kusma, hipokapni, septorinoplasti

Effect of Intraoperative End-Tidal Carbon Dioxide (ETCO2) Levels on Postoperative Nausea and Vomiting in Patients Who Underwent Septorhinoplasty

Aim: Postoperative nausea and vomiting (PONV) is among the most frequent complications of anesthesia. This condition could lead to major difficulties in the clinical monitoring of cases after septorhinoplasty. The aim of the present study was to examine the relationship between end-tidal carbon dioxide (ETCO2) and PONV in low risk patient group for PONV. Material and Method: The study included retrospective analysis of smoking male cases in the age range of 18-45 years who had septorhinoplasty under general anesthesia and was evaluated to have class II diagnosis based on American Society of Anesthesiologists (ASA). The patients who were determined to have ETCO2 levels of 26-30 mmHg constituted the Group 1, while those who had 31-35 mmHg were in Group 2. Demographic data and postoperative nausea and vomiting findings of all cases at the 0th, 2nd, 6th, 12th and 24th hours were evaluated. Results: The study included a total of 73 cases. There were no statistical differences between the two patient groups for demographic data and operation periods (p>0.05). Nausea incidence at the postoperative 2nd and 6th hours were significantly higher in Group 1 compared to the Group 2 (p = 0.007 and p = 0.006, respectively). Postoperative vomiting incidence was not different between the study groups (p>0.05). Conclusion: Based on the results of the present study, maintaining the intraoperative ETCO2 levels in the range of 26-30 mmHg in septorhinoplasty operations results in increased PONV incidence in the early period.

Keywords:

End-tidal carbon dioxide, nausea-vomiting, hypocapnia, septorhinoplasty,

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